Atrophy of the Liver after Occlusion of the Bile Ducts or Portal Vein and Compensatory Hypertrophy of the Unoccluded Portion and its Clinical Importance

Schalm, L; Bax, H R; Mansens, B.J.

doi:10.1016/s0016-5085(19)35886-x

Cited by 116 publications

(29 citation statements)

References 10 publications

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“…PVE is a clinical application of the experimental observation that portal vein ligation leads to atrophy of the manipulated lobe and hypertrophy of the contralateral lobe [17,18]. The contribution of cytokines, hepatotrophic factor, and the hemodynamic changes induced by portal branch occlusion has been discussed [19].…”

Section: Discussionmentioning

confidence: 99%

Expression of Transforming Growth Factor-α and -β in Hepatic Lobes After Hemihepatic Portal Vein Embolization

et al. 2006

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Hemihepatic portal vein embolization (PVE) concomitantly induces atrophy in embolized and compensatory hypertrophy in nonembolized hepatic lobes. The aim of the present study was to evaluate the involvement of growth stimulatory and inhibitory factors in these hepatic lobes after PVE. Liver specimens from the embolized and nonembolized lobes of ten patients who underwent hepatectomy (8-22 days) after undergoing PVE were obtained. Proliferation and apoptosis were examined immunohistochemically using Ki-67 and the Tdt-mediated dUTP-biotin nick end-labeling method. The expression of transforming growth factor-alpha (TGF-alpha) and transforming growth factor-beta (TGF-beta) was also examined by immunohistochemical staining. PVE induced hepatocyte apoptosis in the embolized lobe and hepatocyte proliferation in the nonembolized lobe. TGF-alpha expression in the hepatocytes of the nonembolized lobe was markedly increased, whereas TGF-alpha was also overexpressed, albeit moderately, in the embolized lobe. In contrast, TGF-beta expression in the hepatocytes of the embolized lobe was significantly increased, and TGF-beta expression was also increased, although to a lesser extent, in the nonembolized lobe. The degree of volume changes of the nonembolized lobe and the embolized lobe after PVE was statistically correlated with the ratios of TGF-alpha and TGF-beta expression in these lobes (r = 0.886, P < .0001). In conclusion, these findings indicate that TGF-alpha and TGF-beta expression (assessed by immunohistochemical staining) increase in relation to hepatocyte proliferation and apoptosis, respectively, after PVE in humans and the balance of the two factors may contribute to hepatic atrophy and hypertrophy concomitantly observed in this model.

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Section: Discussionmentioning

confidence: 99%

Expression of Transforming Growth Factor-α and -β in Hepatic Lobes After Hemihepatic Portal Vein Embolization

et al. 2006

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“…17,18 In humans, Honjo et al first performed portal branch ligation for liver tumor in 1961. 19 We pioneered PVE for extensive liver resection for hilar bile duct carcinoma in 1982.…”

Section: Portal Venous Embolizationmentioning

confidence: 99%

The surgical approach to HCC: Our progress and results in Japan

2004

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Due to the prevalence of hepatitis virus infection, the incidence of hepatocellular carcinoma (HCC) is very high in Japan. Many techniques have been devised by Japanese surgeons to reduce the mortality rate after hepatectomy for HCC: preoperative precise evaluation of hepatic functional reserve, portal venous embolization as preoperative preparation, anatomical and nonanatomical limited resections using intraoperative ultrasonography, and intermittent inflow occlusion during liver transection. Several challenging surgical procedures are also being tried for advanced HCC: HCC with portal and hepatic venous tumor thrombus, multiple and/or recurrent HCC, and HCC in the caudate lobe. As a result, the latest national survey of HCC revealed that operative mortality was 0.9% and the 5-year survival rate after surgery was 52%. Living-donor liver transplantation for adult patients with HCC is another surgical treatment developed in Japan. After the success of adult-to-adult living donor liver transplant using a left liver graft in 1993, a right liver graft, a left liver graft with caudate lobe, and a right lateral sector graft were developed. Indications for reconstructing the middle hepatic vein tributaries in right liver grafts were also proposed. Consequently, in our series of 36 patients with HCC who underwent living-donor liver transplantation, operative mortality was 3%, and the 2-year survival rate was 84%.

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“…Atrophy of the liver segment after ligation of its portal venous branch was first observed in animals 17, 18. In humans, Honjo et al first performed portal branch ligation for liver tumor in 1961 19.…”

Section: Zero‐mortalitymentioning

confidence: 99%

Management of radial artery spasm

2004

Cathet Cardio Intervent

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Atrophy of the Liver after Occlusion of the Bile Ducts or Portal Vein and Compensatory Hypertrophy of the Unoccluded Portion and its Clinical Importance

Cited by 116 publications

References 10 publications

Expression of Transforming Growth Factor-α and -β in Hepatic Lobes After Hemihepatic Portal Vein Embolization

Expression of Transforming Growth Factor-α and -β in Hepatic Lobes After Hemihepatic Portal Vein Embolization

The surgical approach to HCC: Our progress and results in Japan

Management of radial artery spasm

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